No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer

被引:26
作者
Carlsson, Sigrid V. [2 ]
Holmberg, Erik [1 ]
Moss, Sue M. [3 ]
Roobol, Monique J. [7 ]
Schroder, Fritz H. [7 ]
Tammela, Teuvo L. J. [4 ,5 ]
Aus, Gunnar [2 ]
Auvinen, Anssi P. [6 ]
Hugosson, Jonas [2 ]
机构
[1] Univ Gothenburg, Dept Oncol, Inst Clin Sci, Sahlgrenska Acad, Gothenburg, Sweden
[2] Univ Gothenburg, Inst Clin Sci, Dept Urol, Sahlgrenska Acad, Gothenburg, Sweden
[3] Inst Canc Res, Canc Screening Evaluat Unit, Sutton, Surrey, England
[4] Tampere Univ Hosp, Dept Urol, Tampere, Finland
[5] Univ Tampere, Sch Med, FIN-33101 Tampere, Finland
[6] Univ Tampere, Tampere Sch Publ Hlth, FIN-33101 Tampere, Finland
[7] Erasmus MC, Dept Urol, Rotterdam, Netherlands
关键词
prostate biopsy; mortality; PSA; prostate cancer; screening; TRANSRECTAL BIOPSY; COMPLICATION RATES; NEEDLE-BIOPSY; ENDOSCOPIC TREATMENT; ANAEROBIC INFECTION; SEXTANT BIOPSIES; RISK-FACTORS; ACCEPTABILITY; PROGRAM;
D O I
10.1111/j.1464-410X.2010.09712.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Level of Evidence 1b What's known on the subject? and What does the study add? Prostate biopsy can potentially have fatal outcome. This is, however, rare. In the literature a few fatal cases of septicaemia have been reported as well as life-threatening rectal bleeding. Prostate biopsy is not associated with excess mortality and fatal complications seem to be very rare in a screening setting. OBJECTIVE center dot To assess possible excess mortality associated with prostate biopsy among screening participants of the European Randomized Study of Screening for Prostate Cancer (ERSPC). patientS AND METHODS center dot From three centres in the ERSPC (Finland, The Netherlands and Sweden) 50 194 screened men aged 50.2-78.4 years were prospectively followed. A cohort of 12 959 first-time screening-positive men (i.e. with biopsy indication) was compared with another cohort of 37 235 first-time screening-negative men. center dot Overall mortality rates (i.e. other cause than prostate cancer mortality) were calculated and the 120-day and 1-year cumulative mortality were calculated by the Kaplan-Meier method, with a log-rank test for statistical significance. center dot Incidence rate ratios (RR) and statistical significance were evaluated using Poisson regression analyses, adjusting for age, total PSA level, screening centre and whether a biopsy indication was present, or whether a biopsy was actually performed or not. RESULTS center dot There was no statistically significant difference in cumulative 120-day other cause mortality between the two groups of men: 0.24% (95% CI, 0.17-0.34) for screening-positive men vs 0.24% (95% CI, 0.20-0.30) for screening-negative men (P = 0.96). This implied no excess mortality for screening-positive men. center dot Screening-positive men who were not biopsied (n = 1238) had a more than fourfold risk of other cause mortality during the first 120 days compared to screening-negative men: RR, 4.52 (95% CI, 2.63-7.74) (P < 0.001), adjusted for age, whereas men who were actually biopsied (n = 11 721) had half the risk: RR, 0.41 (95% CI, 0.23-0.73) (P = 0.002), adjusted for age. center dot Only 14/31 (45%) of the screening-positive men who died within 120 days were biopsied and none died as an obvious complication to the biopsy. CONCLUSION center dot Prostate biopsy is not associated with excess mortality and fatal complications appear to be very rare.
引用
收藏
页码:1912 / 1917
页数:6
相关论文
共 28 条
[1]   Fatal Clostridium sordellii ischio-rectal abscess with septicaemia complicating ultrasound-guided transrectal prostate biopsy [J].
Borer, A ;
Gilad, J ;
Sikuler, E ;
Riesenberg, K ;
Schlaeffer, F ;
Buskila, D .
JOURNAL OF INFECTION, 1999, 38 (02) :128-129
[2]   Endoscopic therapy of a massive rectal bleeding after prostate biopsy [J].
Braun, Kay-P. ;
May, Matthias ;
Helke, Christian ;
Hoschke, Bernd ;
Ernst, Helmut .
INTERNATIONAL UROLOGY AND NEPHROLOGY, 2007, 39 (04) :1125-1129
[3]   ANAEROBIC INFECTION AS A CONSEQUENCE OF TRANS-RECTAL PROSTATIC BIOPSY [J].
BRESLIN, JA ;
TURNER, BI ;
FABER, RB ;
RHAMY, RK .
JOURNAL OF UROLOGY, 1978, 120 (04) :502-503
[4]   FATAL ANAEROBIC INFECTION FOLLOWING TRANSRECTAL BIOPSY OF A RARE PROSTATIC TUMOR [J].
BREWSTER, SF ;
ROONEY, N ;
KABALA, J ;
FENELEY, RCL .
BRITISH JOURNAL OF UROLOGY, 1993, 72 (06) :977-978
[5]   Massive rectal bleeding following transrectal ultrasound-guided prostate biopsy [J].
Brullet, E ;
Guevara, MC ;
Campo, R ;
Falcó, J ;
Puig, J ;
Prera, A ;
Prats, J ;
Del Rosario, J .
ENDOSCOPY, 2000, 32 (10) :792-795
[6]   SIDE-EFFECTS AND PATIENT ACCEPTABILITY OF TRANSRECTAL BIOPSY OF THE PROSTATE [J].
CLEMENTS, R ;
AIDEYAN, OU ;
GRIFFITHS, GJ ;
PEELING, WB .
CLINICAL RADIOLOGY, 1993, 47 (02) :125-126
[7]  
Da Silva Eloisio, 1999, Archivos Espanoles de Urologia, V52, P167
[8]   Severe bleeding following transrectal tru-cut prostatic biopsy [J].
Dauleh, MI ;
Byrne, DJ .
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 1996, 30 (02) :153-154
[9]   URINARY CONTAMINATION AS A RESULT OF TRANSRECTAL BIOPSY OF PROSTATE [J].
DAVISON, P .
JOURNAL OF UROLOGY, 1971, 105 (04) :545-&
[10]   Legal pitfalls in the diagnosis of prostate cancer [J].
Dunn, IB ;
Kirk, D .
BJU INTERNATIONAL, 2000, 86 (03) :304-307